Panel Pushes Vaccine for Pregnant Women

Amid Whooping Cough Crisis, New Guidelines Recommend Mothers Get Vaccinated at Each Pregnancy

By

Jennifer Corbett Dooren

Jan. 28, 2013 7:07 p.m. ET

Pregnant women should be vaccinated against whooping cough during each pregnancy to protect their infants, as public-health officials warn of a steep rise in the disease, according to new recommendations from a federal advisory committee.

ENLARGE

Susan Bojka, manager of the Family Birthing Center in Waterbury, Conn., prepares the pertussis vaccine for a new mother last fall.
Associated Press/Republican-American

Federal guidelines currently call for all adults, including pregnant women, to receive the whooping cough vaccination one time.

The Centers for Disease Control and Prevention said more than 41,000 cases of whooping cough were reported to the agency last year, the highest level in more than 50 years and more than double the 2011 total. The disease was linked to 18 deaths in 2012, with the majority of them babies younger than 3 months old.

The new recommendation for pregnant women is contained in the 2013 version of the U.S. adult immunization schedule, updated yearly by the CDC's vaccine advisory panel. It says women should receive a vaccine for tetanus, diphtheria and pertussis, together known as Tdap, toward the end of pregnancy, or between 27 and 36 weeks' gestation. The vaccination is intended to offer protection against pertussis, the bacteria that causes whooping cough, until babies are old enough to begin receiving their own vaccinations against the disease starting at 2 months of age.

Mothers who are vaccinated during pregnancy produce antibodies to pertussis and other bacteria that are passed on to babies before they are born, said Sandra A. Fryhofer, a liaison to the CDC's advisory committee on immunization practices and who represents the American College of Physicians.

"Clearly pertussis is back and we are in danger of losing control" of the disease, said H. Cody Meissner, a professor of pediatrics at Tufts University School of Medicine and a liaison to the CDC's vaccine advisory panel. "People forget how bad pertussis can be."

The advice is at odds with other federal regulations on the vaccine. The U.S. Food and Drug Administration has only approved it for one-time use, rather than multiple uses. But doctors don't need FDA approval to administer the vaccine repeatedly, so the agency's stance won't necessarily hinder adherence to the new guidelines.

Whooping cough is highly contagious and spread through coughing and sneezing. The disease can cause persistent, violent and rapid coughing until the air is gone from the lungs and people are forced to inhale with a loud "whooping" sound. The cough can last for weeks.

The adult vaccination schedule was published online Monday in the Annals of Internal Medicine and will be available on the CDC's website. An updated 2013 immunization schedule for children and adolescents also recommends pregnant adolescents receive the Tdap vaccine.

The Tdap vaccine is sold as Boostrix by
GlaxoSmithKline
PLC and as Adacel by a unit of
Sanofi
SA
. Boostrix has FDA approval for use in people 10 years old and above while Adacel is approved for in people ages 11 through 64.

Babies and children are vaccinated against pertussis, diphtheria and tetanus through a similar vaccine that's referred to as Dtap in a five-dose series during infancy and up to age 6. Additional vaccinations are recommended when children are 11-to-12 years old and for adults because it's believed that immunity to pertussis from childhood vaccines wanes over time.

The advisory panel voted to adopt the recommendation last October. The new immunization schedules have also been approved by medical groups that include the American College of Physicians and the American College of Obstetricians and Gynecologists.

The new guidelines also recommend people with mild egg allergies receive a flu shot rather than FluMist, a vaccination made by a unit of
AstraZeneca
PLC that is delivered through the nose. Prior recommendations had suggested that anyone with egg allergies not receive an influenza vaccine. Now, only people with severe egg allergies are advised not to get an influenza vaccine. Flu vaccines are recommended annually for people ages 6 months and older.

Corrections & Amplifications H. Cody Meissner is a professor of pediatrics at Tufts University School of Medicine and also works at Tufts Medical Center. An earlier version of this article incorrectly said he is a professor at Tufts University Medical Center.

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